Abstract: Objective To explore the clinical characteristics and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL) and to compare the prognostic value of several stratification models for evaluating its prognosis. Methods A total of 79 AITL patients were selected and their clinical data were collected for retrospective analysis. The patients were stratified into risk categories based on the International Prognostic Index (IPI), the Prognostic Index for Peripheral T-cell Lymphoma (PIT), the AITL Prognostic Index (PIAI), and a newly established prognostic scoring system. Survival and prognostic analyses were performed using the Kaplan-Meier method and Cox regression model. Receiver operating characteristic (ROC) curves were plotted to compare the predictive value of different prognostic scoring systems. Results The median age at onset was 66 years (29-83 years). Among the 73 evaluable patients, 27 (37.0%) achieved complete remission, 20 (27.4%) achieved partial remission, and the objective response rate was 64.4%. The median overall survival (OS) was 17 months (1.0-107.0 months), with 3-year and 5-year OS rates of 39.76% and 26.51%, respectively. The 3-year and 5-year progression-free survival (PFS) rates were 23.58% and 17.33%, respectively. Based on multivariate analysis, poor prognostic factors included age >65 years, ECOG score >1, C-reactive protein (CRP) >20 mg/L, and prognostic nutritional index (PNI) <44.35. The new prognostic scoring system was established, which performed better at distinguishing low, low to medium, medium to high and high risk patients than the IPI, PIT, and PIAI scores. The area under the curve (AUC) for the new prognostic scoring system was 0.825 9 (95% CI 0.715 7-0.936 1) for OS and 0.859 2 (95% CI 0.751 3-0.967 0) for PFS. Conclusions AITL predominantly affects advanced elderly patients, with most diagnosed at stage III-IV, and the disease progresses rapidly with poor treatment outcomes and prognosis. Compared with the IPI, PIT, and PIAI scores, the newly established prognostic scoring system, based on age >65 years, ECOG score >1, CRP >20 mg/L, and PNI <44.35, offers higher diagnostic accuracy and is better suited for identifying high-risk patients.